Abstract
Background: Forearm fractures amongst children are quite a common presentation. The accuracy of correct alignment in forearm bones is important as it determines the degree of forearm rotation (pronation-supination). However in children due to the potential for continuous growth, a degree of angulation is acceptable. The aim of this study was to determine the effect of angulation of forearm fracture on forearm rotation using computer stimulation. Methods: Using a 3D computer modelling software (Wildfire Pro Engineer 4.0, Creo by PTC, Needham, MA), an accurate to scale model of the radius and ulna was replicated from a 7 year old forearm. A realistic representation of pronation/supination of the forearm was applied and a fracture at the junction of proximal one third and distal two third was created. A rotational simulation was created and ended when maximum pronation and supination was reached. Maximum pronation and supination was reached when either no more rotation could occur due to a misalignment of the radius and ulna or there was a collision of the bones. The simulation was repeated in increments of angulation of 2° up to 26°. The angulations that resulted in a combined range of motion (50° pronation and 80° supination) less than 130° were recorded as unacceptable and the others were as acceptable. Findings: The study showed that radius angulation fracture of >16° in the proximal third of the radius would result in an unacceptable reduction of pronation-supination to less than 130°. Conclusion: Patients with more >16° of radius angulation in a distal third shaft fracture of the radius may result in clinical reduction in forearm rotation.
Highlights
Fractures of the forearm in children are quite common accounting for 25% to 50% of all childhood fractures, with the most affected age group being 5 to 14 years of age (26%) [1]-[3]
Due the anatomical arrangement of the forearm bones, if one bone is angulated, it is very likely that some pronation-supination would be lost [4] [5]
Maintenance of a normal forearm rotation is dependent on both bones being fully intact and anatomically aligned [6]
Summary
Fractures of the forearm in children are quite common accounting for 25% to 50% of all childhood fractures, with the most affected age group being 5 to 14 years of age (26%) [1]-[3]. In children with growth potential, the younger the child is, the lesser angulation of fracture is and the better the result is because of more years available for the bones to remodel and restore normal forearm rotation [7]-[10]. Maximum pronation and supination was reached when either no more rotation could occur due to a misalignment of the radius and ulna or there was a collision of the bones. Findings: The study showed that radius angulation fracture of >16 ̊ in the proximal third of the radius would result in an unacceptable reduction of pronation-supination to less than 130 ̊. Conclusion: Patients with more >16 ̊ of radius angulation in a distal third shaft fracture of the radius may result in clinical reduction in forearm rotation
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call